Individual
DR. THOMAS R BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2409 FAIROAK DR, FORT WAYNE, IN 46809-2301
(260) 747-5745
Mailing address
2409 FAIROAK DR, FORT WAYNE, IN 46809-2301
(260) 747-5745
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7973
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1091
PHP
IN
01
—
777279
UNITED CONCORDIA
IN
Enumeration date
02/21/2007
Last updated
07/09/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us